Lymphogranuloma venereum (LGV) is caused by one of the aggressive L serotypes of Chlamydia trachomatis usually acquired sexually. It is an obligatory intracellular and Gram-intermediate organism. The incubation period is 3–30 days. It is more commonly found in the sea ports of the Far East, Malaysia, Africa, and South America. Initial lesion is a painless papule, pustule or ulcer in the vulva, urethra, rectum or the cervix. The inguinal nodes are involved and feel rubbery. There is acute lymphangitis and lymphadenitis. The glands become necrosed and abscess (bubo) forms. Within 7–15 days, the bubo ruptures and results in multiple draining sinuses and fistulas. The healing occurs with intense fibrosis with lymphatic obstruction. The secondary phase is noted by painful adenopathy. The classical clinical sign of LGV is the “groove sign”, a depression between the groups of inflamed nodes.
The lymphatic obstruction leads to vulval swelling whereas lymphatic extension to the vulva, vagina, or rectum leads to ulceration, fibrosis, and stricture of the vagina or rectum.
(i) Vulval elephantiasis,
(ii) Perineal scarring and dyspareunia,
(iii) Rectal stricture
(iv) Sinus and fistula formation.
(a) Culture and isolation (Lymph node aspiration): of LGV (Chlamydia serotypes L1,2,3) is confirmatory.
(b) Detection of LGV antigen in pus obtained from a bubo with specific monoclonal antibodies using immunofluorescence method.
(c) Detection of LGV antigen by ELISA method.
(d) LGV complement fixation test—when positive
with rising titer (>1 : 64).
(e) Intradermal Frei test is non-specific and unreliable.
Prevention—Use of condom or to avoid intercourse with a suspected infected partner.
HOMOEOPATHIC MANAGEMENT OF LYMPHOGRANULOMA VENERUM: -
Homoeopathy is one of the most popular holistic systems of medicine. The selection of remedy is based upon the theory of individualization and symptoms similarity by using holistic approach. This is the only way through which a state of complete health can be regained by removing all the sign and symptoms from which patient is suffering.
The aim of homoeopathy is not only to treat infection symptoms but to address its underlying cause and individual susceptibility. As far as therapeutic medication is concerned, several medicines are available. These can be managed on the selection of basis of the cause, sensation, modalities of the complaints.
The useful remedies are: -